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Federal forms, ICRs, and supporting documents

Information Collection

Rural Health Clinic COVID-19 (RHC COVID-19) Testing Program Data Collection

IC 243770 under ICR 202109-0906-001 · OMB 0906-0056.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Other-Tracked Changes
Other-Tracked Changes
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Rural Health Clinic COVID-19 (RHC COVID-19) Testing Program Data Collection
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 HRSA FORHP COVID-19 Data Report 9.2021_CLEAN.docx FORM - HRSA FORHP COVID-19 Data Report 9.2021_CLEAN.docx Yes Yes Fillable Fileable
Other-Tracked Changes FORM - HRSA FORHP COVID-19 Data Report 9.2021 TRACK.docx Yes Yes Fillable Fileable

Health Health Care Services

 

2,301 2,301
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 43,719 0 14,847 0 0 28,872
Annual IC Time Burden (Hours) 14,427 0 7,209 0 0 7,218
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.